2117 LOMBARD AVE 2016-09-20 - Laserfiche WebLink

i InMMon Y Name and CcmtacA Into: date Backwater Revenfion deNi (B D)was fnstgW. Datethislofm was Installation Property Owtv Nanv aid Owed Into: r� ��' � / PropeAyAddress. `�' � �� p ,a Pre4installation Inspectlon C llwt: A#item ivud b e 0ioc ed Yes' a ofdor for a BWD to be considatedfor kWagatian � Is ire a la e wrt orlevO of the house that i5 at or near assurnediewer main eti ? Y Cj- s Are there fiOjm in te hDuse loc&d bekw the upstre i s -r m h rzrri elevation? No' Is the We u4r f rrentt 1t;3 T C EED from !t. r a.w ups(does r ,have a M inslal: )? es F NO Site Irmpecilon Checklist AO Berns rvu be c sc 'Yes'befwra rasp r?is s r to Was side sewer V r`rrs W ted from in to seiu? ales ion: Does side sewer have at bast t slope from ft bwWiN to sewer ? Oft o Dqscriba- Haw all building sem drain connections to the sevw Eeei, &ntified and locales , <io Have all prop-arty stoffn d4nage c onne s to t'+ side sewer been idenYes l N! Has e f r ' dpi s a ru t tc to fop, ? No i InstobtionDetails: 1, `hat type aM brand of BAD%ras installed at this site(Clearw Check SM,GriTxler pump,etc.): �—�e4u Where was the d/avice insta1ed(general descftption,#bch rnap)9 �a -ff rK Qa Was theme any o3 r se r storm dralnaga wak,cornploled in coryunclion wi i ft 6 ?Is so please e r , ,ire doanspouts and silo&Aage disconnectedframe upstream the 61 .w/- Y [J No C rets: Does MID positioniflg mala minimum A requirement of>1%? es E]NO Coq)meiils: Can 811VD be pled out for inspection and mainferiance atter l scree'? Li6es n No I�RAO Pocked sato the pmper position aM tthra b view ti laten d? NO We the BAD cover " aticfi co 6anaWe atea)fh' Mic load I arri1 cover( i Surface)I access batch(building) Was oporty owner slrovin ft oation of the t�WIND? ao b . tIo mrw s: /77 Installer's Slpaturw. Date, Revision-"2 Friday.Seplembef 12,201A E